摘要
目的探讨药物不良事件(ADE)对肾移植受者再入院及移植肾存活的影响。方法检索医院信息系统,收集2008年1月至2018年12月于新疆军区总医院北京路医疗区行肾移植术且术后再入院至少1次(截至2020年12月)患者的病历资料进行回顾性分析。提取患者相关数据(性别、年龄、体重、民族、肾移植术情况、术后免疫抑制治疗方案、再入院情况以及移植肾存活时间等),使用自行建立的全面触发工具审查患者再入院病历,检测ADE信号,采用Karch和Lasagna法评估ADE与再入院的相关性,根据评估结果将患者分为ADE相关再入院组(ADE入院组)和非ADE相关再入院组(非ADE入院组),比较2组患者的临床特征和移植肾累积存活率。结果纳入分析的患者共198例(再入院1426例次),男性154例,女性44例;年龄14~62岁;汉族118例(59.6%);免疫抑制治疗药物包括环孢素、他克莫司、西罗莫司等;94例(47.5%)患者的240例次(16.8%)再入院与ADE相关。ADE入院组患者诊断病症数和术后再入院次数多于、住院时间长于非ADE入院组[4(3,6)种比3(2,5)种,P=0.001;6(3,9)次比4(2,8)次,P=0.022;20(13,33)d比14(11,25)d,P=0.010]。Kaplan⁃Meier生存曲线分析显示,ADE入院组患者术后1、3、5、10年移植肾累积生存率分别为90.1%、84.1%、79.0%、57.6%,非ADE入院组分别为99.0%、94.7%、90.8%、80.4%,组间差异有统计学意义(P=0.011)。结论ADE可导致肾移植受者再入院次数增加,住院时间延长,移植肾累积存活率降低,应加强对肾移植受者ADE的监测。
Objective To explore the impact of adverse drug events(ADE)on readmission in renal transplant recipients and survival of the transplanted kidney.Methods The hospital information system was searched and medical records of patients who underwent renal transplantation in Beijing Road Medical Area of Xinjiang Military Region General Hospital from January 2008 to December 2018 and were re⁃admitted at least once(as of December 2020)were collected and analyzed retrospectively.Patient information such as gender,age,weight,ethnicity,kidney transplantation status,postoperative immunosuppres⁃sive treatment plan,readmission status,and kidney transplant survival time was extracted and the ADE signals were detected through reviewing the patient re⁃admission medical history using a self⁃established global trigger tool.The correlation between ADE and readmission was evaluated by Karch and Lasagna method;patients were included in the ADE⁃related readmission group(ADE admission group)and the non⁃ADE⁃related readmission group(non⁃ADE admission group)based on the correlation results.The clinical characteristics and the cumulative survival rate of kidney transplants between the 2 groups were compared.Results A total of 198 patients(1426 times of readmission)were entered in the analysis,including 154 males and 44 females with an age of 14⁃62 years,and 118(59.6%)were Han nationality.The immunosuppressive drugs included cyclosporine,tacrolimus,sirolimus,etc.After renal transplantation,240 times of readmission(16.8%)in 94 patients(47.5%)were associated with ADE.In the ADE readmission group,the number of diagnosed diseases and postoperative readmission times were more and the length of hospital stay was longer than those in the non⁃ADE readmission group[4(3,6)vs.3(2,5),P=0.001;6(3,9)times vs.4(2,8)times,P=0.022;20(13,33)days vs.14(11,25)days,P=0.010].Kaplan⁃Meier curve showed that the 1⁃,3⁃,5⁃,and 10⁃year cumulative survival rates of kidney transplants were 90.1%,84.1%,79.0%,and 57.6%in ADE⁃related readmiss
作者
韩忠灵
吴建华
薛瑜峰
杨立
郑海燕
杨靖
滕亮
Han Zhongling;Wu Jianhua;Xue Yufeng;Yang Li;Zheng Haiyan;Yang Jing;Teng Liang(Department of Pharmacy,Beijing Road Medical Area of Xinjiang Military Region General Hospital,Urumqi 830000,China;Department of Pharmacy,People′s Hospital of Xinjiang Uygur Autonomous Region,Urmuqi 830054,China;Department of Nephrology,Beijing Road Medical Area of Xinjiang Military Region General Hospital,Urumqi 830000,China;Department of Pharmacy,the First Affiliated Hospital of Xinjiang Medical University,Urmuqi 830054,China;the Pharmacy Department of Sichuan Jinxin Women&Children Hospital,Chengdu 610011,China)
出处
《药物不良反应杂志》
CSCD
2022年第1期24-29,共6页
Adverse Drug Reactions Journal
基金
新疆军区总医院北京路医疗区青年培育科研项目(2020jzbj1010)。
关键词
肾移植
免疫抑制剂
移植排斥
危险因素
药物相关副作用和不良反应
全面触发工具
Kidney transplantation
Immunosuppressive agents
Graft rejection
Risk factors
Drug⁃related side effects and adverse reactions
Global trigger tool
